Jackson, Tammy Lynn

Jackson, Tammy Lynn is an sole proprietor health care provider with primary practice located at 1014 Sun Meadow Ct , College Station TX 77845-7291. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Counseling, Behavioral Health & Social Service Providers / Adult Development & Aging. Behavioral Health & Social Service Providers / Adult Development & Aging is her primary health care specialty. Jackson, Tammy Lynn can be contacted via phone (979) 217-1311.

Contact Information

Primary practice address
1014 Sun Meadow Ct College Station TX 77845-7291
Phone: (979) 217-1311
Fax: (855) 604-0969
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X 31418 Texas
Behavioral Health & Social Service Providers / Counseling 103TC1900X
Behavioral Health & Social Service Providers / Adult Development & Aging 103TA0700X 31418 Texas

Profile Details

NPI number 1619958758
LBN Legal business name Jackson, Tammy Lynn
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 7th, 2005
Last updated Aug 25th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619958758 NPPES
Texas MEDICAID 158249604

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